Good oral hygiene practices, such as brushing teeth regularly, are critical to maintaining dental and periodontal health. In special needs and older populations with reduced manual dexterity, brushing is not rigorous enough to maintain oral hygiene, leading to a higher incidence of caries and periodontal disease in these cohorts. Poor oral health not only affects nutritional and functional status adversely, it also has serious implications on quality of life with a potential increase in the susceptibility of these individuals to a number of systemic ailments. This provides the impetus to develop a novel, hands- free device for tooth cleaning, with the objective of improving oral and systemic health in special needs and older populations. In this proposal, we hypothesize that a novel hands-free ultrasound generating device coupled with specially formulated gels will be effective in removing dental biofilms in vitro. To test this hypothesis, we propose to: (1) Develop and test ultrasound-generating piezo-fiber based composite strips molded into a form that can be placed over the teeth and gums, in conjunction with gels that function to enhance the action of the ultrasound, and (2) Determine the efficacy of the device in cleaning of typodont and human teeth covered with an experimental biofilm in vitro as compared to conventional brushing. The scientific and technological novelty lies in developing and using specialized ultrasound strips combined with uniquely formulated gels placed adjacent to the teeth to achieve biofilm removal. The gels will serve to provide a medium for propagating ultrasonic pressure waves to tooth surfaces AND to reduce ultrasonic energies required to cause cavitations (microscopic bubbles) that then expand and contract rapidly next to tooth surfaces and serve to clean teeth. The rapid expansion and contraction of these microscopic bubbles provides the same energies as those generated by the motion of brushes against tooth surfaces and are expected to dislodge biofilm within a maximum of two minutes. A series of gels will be developed that will enhance the action of ultrasound and will function to clean and renew the tooth. We anticipate that a device will be developed which can be used to clean teeth in an effective manner and with results comparable to brushing. The development of this device has important public health implications, since it will improve oral and possibly systemic health in special needs and older populations, and may also reduce healthcare costs. PUBLIC HEALTH RELEVANCE: Cleaning of teeth by regular brushing is extremely important towards maintaining oral health, which in turn can impact on overall health. Many older individuals and special needs populations lack the hand mobility to effectively clean their teeth, leading to oral and possibly systemic disease. This causes significant public health disparities in these populations. This application proposes the development and testing of a novel hands-free toothcleaning device, using ultrasound in association with specially formulated gels. The successful development of such a device will have a major public health impact by improving oral and general health of older individuals and those with special needs. Such improvements in oral and general health will also decrease healthcare costs to society.